Healthcare Provider Details

I. General information

NPI: 1154563815
Provider Name (Legal Business Name): SAINT LUKE'S HOSPITAL OF TRENTON
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/27/2009
Last Update Date: 03/27/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

103 2ND ST.
JAMESPORT MO
64648-8206
US

IV. Provider business mailing address

701 E 1ST ST
TRENTON MO
64683-2402
US

V. Phone/Fax

Practice location:
  • Phone: 660-684-6244
  • Fax:
Mailing address:
  • Phone: 660-684-6244
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QC0050X
TaxonomyCritical Access Hospital Clinic/Center
License Number413-14
License Number StateMO

VIII. Authorized Official

Name: KAREN S COLE
Title or Position: CEO
Credential:
Phone: 660-359-5621